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Effectiveness of Nature Walks in Depressed Adults

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Know the risks and potential benefits of clinical studies and talk to your health care provider before participating. Read our disclaimer for details.
 
ClinicalTrials.gov Identifier: NCT03996785
Recruitment Status : Recruiting
First Posted : June 25, 2019
Last Update Posted : June 25, 2019
Sponsor:
Collaborator:
Social Sciences and Humanities Research Council of Canada
Information provided by (Responsible Party):
Marie-Claude Geoffroy, McGill University

Brief Summary:

Over the past few years, a growing number of campaigns from around the world, including Canada, are highlighting the positive impact of spending time in nature on well-¬being. Indeed, mounting evidence suggests that spending time with nature is associated with a myriad of affective and cognitive benefits. Surprisingly few studies to date have tested the assumption that walking in nature versus in urban settings could alleviate stress and depressive symptoms in clinically depressed adults.

The main purpose of this study is to investigate the effectiveness of walking in nature versus in urban settings to improve depression related symptoms and reduce stress. The trial included 2 primary outcomes: patients stress levels (salivary cortisol) and depression-related symptoms (eg, affect, rumination, executive functioning)


Condition or disease Intervention/treatment Phase
Experimental Behavioral: Walking in Urban setting Behavioral: Walking in nature setting Not Applicable

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 62 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Supportive Care
Official Title: Investigations of Immediate and Short-term Effects of Nature Walks on Stress and Depression-related Symptoms
Actual Study Start Date : June 18, 2019
Estimated Primary Completion Date : September 30, 2020
Estimated Study Completion Date : September 30, 2020

Resource links provided by the National Library of Medicine


Arm Intervention/treatment
Active Comparator: Urban

Patients will go for a silent 60-minute walk in an urban setting. The walk will take place in the months of June, July, August and September between 10:00 to 11:00 am.

Participants will walk in groups of two to three participants accompanied by two research assistants trained in mental health (doctoral students in psychology). The urban walk will be located on Boulevard de la Vérendrye with large arteries with three to four lanes.

Behavioral: Walking in Urban setting
Walking for 60 minutes as described above

Experimental: Nature

Patients will go for a silent 60-minute walk in a nature park setting. The walk will take place in the months of June, July, August and September between 10:00 to 11:00 am.

Participants will walk in groups of two to three participants accompanied by two research assistants trained in mental health (doctoral students in psychology).

The nature walk will take place at Parc Angrignon, an area of 96 hectares, one of Montreal's largest green and biodiverse spaces with a forest of 20 000 trees and a pond surrounded by willow trees.

Behavioral: Walking in nature setting
Walking for 60 minutes as described above




Primary Outcome Measures :
  1. Change in morning salivary cortisol secretion pattern [ Time Frame: Day 1 ]
    Salivary cortisol levels will be measured via the collection of passive drool using a straw.


Secondary Outcome Measures :
  1. Change in affect from baseline up to 72 hours post-walk [ Time Frame: Day 1 to Day 3 ]
    Positive and Negative Affect Schedule (PANAS) The original PANAS is a 20-item self-rated questionnaire measuring positive affect (e.g., "excited") and negative affect (e.g., "upset"). Four items of sadness (sad, depressed, discouraged, despondent) were added to the negative affect subscale to assess the level of induced sadness. Participants indicate to what extent they feel each affect "right now—that is, at the present moment" using a Likert scale ranging from one (very slightly or not at all) to five (extremely).

  2. Change in Executive Functions [ Time Frame: The Stroop test will be administered at 2 time points: 1) before the walk (between 9:45-10:30); 2) after the walk (between 11:30-11:50) ]
    The stroop color word test is a widely used task to assess selective attention and inhibitory control. In the first block of this task (A), color words (red, blue, yellow, green) printed in black ink are presented in random order and participants are asked to read out loud the words. In the second block (B), solid color patches in one of the same four colors are shown and participants name the colors. Finally, in the third block (C), color words are printed in an incongruous ink color and participants must name the ink color (e.g. GREEN [typed in red]; response = red). Participants are asked to complete each block as quickly and accurately as possible and the time to complete each trial is calculated and averaged for each block. An interference score is calculated as followed: C - [(A + B) /2].

  3. Change in suicidal Ideations [ Time Frame: Day 1 ]
    Severity of Suicidal Ideations The severity of current suicidal ideation will be assessed with three items derived from a prior study of momentary assessment of suicidal risk: "How intense is your desire to kill yourself right now"?; "How strong is your intention to kill yourself right now"?; "How strong is your ability to resist the urge to kill yourself right now"? Each item is scored on a scale from 0 (not strong [intense] at all) to 4 (very strong [intense]).

  4. Change in depressive symptoms [ Time Frame: Day 1 to Day 2 ]
    The Beck Depression Inventory (BDI-II) The BDI is a widely used 21‐item depression inventory with good internal consistency (α = .93 in the current sample) and validity. Items are answered on a 4-point scale from 0 to 3.

  5. Change in rumination [ Time Frame: Day 1 ]
    The Rumination-Reflection Questionnaire (RRQ) The RRQ is a 24-item self-reported questionnaire assessing both self-rumination and self-reflection, 57 with 12 items corresponding to each subscale. Participants rate the degree to which they engage in self- rumination (e.g. "sometimes it is hard for me to shut off thoughts about myself") and self-reflective thoughts (e.g. "I love to meditate on the nature and meaning of things") on a Likert scale ranging from one (strongly disagree) to five (strongly agree)

  6. Change in irritability [ Time Frame: Day 1 to Day 3 ]
    The Brief Irritability Test (BITe): The BITe is a 5-item self-report measure of irritability that is suitable for use among men and women. Participants respond to statements using a 6-point Likert scale ranging from Never to Always. Items include the following five statements: "I have been grumpy"; "I have been feeling like I might snap"; "Other people have been getting on my nerves".



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Ages Eligible for Study:   18 Years to 65 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Men and women aged between 18 and 65 years, inclusively, with a body mass index (BMI) < 30;
  • Ability to speak French or English;
  • Current major depressive episode, major depressive disorder (DSM-V); as per the Hamilton Depression Rating Scale - 21 items ≥ 10;

Exclusion Criteria:

  • - Acute psychotic symptoms;
  • Acute suicidal intent (within 48 hours);
  • Unable to walk for 60 min or serious medical reasons (e.g. major surgery)
  • Heart condition as per history or detected on electrocardiogram

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT03996785


Contacts
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Contact: Marie-Claude Geoffroy, Phd 514-691-5931 marie-claude.geoffroy@mcgill.ca

Locations
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Canada, Quebec
Douglas Mental Health University Institute Recruiting
Montreal, Quebec, Canada, H4H 1R3
Contact: Despina Bolanis, MsC    514-398-4257    despina.bolanis@mail.mcgill.ca   
Sponsors and Collaborators
McGill University
Social Sciences and Humanities Research Council of Canada
Investigators
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Principal Investigator: Marie-Claude Geoffroy, PhD McGill University
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Responsible Party: Marie-Claude Geoffroy, Assistant professor, McGill University
ClinicalTrials.gov Identifier: NCT03996785    
Other Study ID Numbers: IUSMD-18-33
First Posted: June 25, 2019    Key Record Dates
Last Update Posted: June 25, 2019
Last Verified: June 2019
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No

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Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No
Keywords provided by Marie-Claude Geoffroy, McGill University:
Clinical depression
Stress
Group-walking
Walking condition (nature vs urban)